The most dangerous man in American health care is Greg Glassman. That’s right, the man who will make the biggest difference in making our country healthier, and thereby reducing the cost of providing health care, is a fitness trainer from Santa Cruz California. And you have no idea who he is.

That’s okay, though; you’re in good company. There are lots of really important, really influential people in American healthcare who have never heard of Greg Glassman. Donald Berwick, head of the Centers for Medicare and Medicaid Services? Not a clue. Toby Cosgrove, CEO of the vaunted Cleveland clinic foundation? Nope, never heard of him. So it goes, as well, for the presidents and executive vice presidents of all the various and sundry medical “letter” organizations like the AMA, the American Association of ophthalmology, and the like. The man who might hold the key to economic healthcare salvation is not even a blip on the margins of the healthcare establishment’s radar screens.

So what’s the big deal? Why is Greg Glassman the most dangerous man in American healthcare? There are two reasons, actually. First, he is right. Glassman has identified not only the most fundamental and foundational problem with the health of Americans, but he has also discovered, defined, and implemented the solution. Americans are not fit. There is an appalling lack of physical fitness in the populace. Fat and slow, or skinny–fat and weak, we are a nation of the unfit. What Science Daily calls “frailty” in an article linking a lack of fitness to poor health outcomes (ScienceDaily.com/releases/2011/04/110426122948.htm), Glassman calls decrepitude. Skinny or fat, how healthy can you be if you can’t get yourself out of a chair without assistance?

Somewhere around 2001 Greg Glassman co–founded a fitness system which he dubbed “Crossfit”(http://www.crossfit.com). He offered the first actionable definition of fitness ever created: work capacity across broad time and modal domains. How much stuff can you move, how far, how quickly. It’s not enough to be strong, you must also be able to travel long distances. By the same token, it’s not enough to be able to travel long distances if you are not strong enough to lift your own body. This definition led to a measurement of fitness, power output or work.

To achieve this level of fitness Crossett offers the equivalent of a prescription. Exercise should consist of “constantly varied, high intensity, functional movements.” Intensity is the key. Fitness gains are not only magnified but are achieved in the most efficient manner when the exercise is performed at relatively high intensity. Functional movements include fitness standards like running, swimming and biking, but also weight training using major lifts like the deadlift, the clean, and the squat. Crossfit has returned those staples of gym classes in the 60′s, pull-ups, push-ups, and squats, to a prominence not seen since the days of Kennedy’s Presidential Council on Fitness.

Caloric intake matters; you can’t out train a bad diet or a bad lifestyle. Crossfit’s dietary prescription is quite simple: “eat meats and vegetables, nuts and seeds, some fruit, little starch and no sugar. Keep intake to levels that will support exercise but NOT BODY FAT.” Crossfit preaches the merits of both quantity and quality when if comes to food. Carbohydrates with a low glycemic index, protein containing all essential amino acids, AND FAT are all essential to producing physical fitness. Food should be seen as fuel and should be measured as such. Even the highest quality foods consumed in the most balanced proportions will produce increased body fat and decreased fitness if taken in too high volume

A funny thing happened on the way to revolutionizing the fitness industry. In addition to increased strength, increased endurance, and decreased body fat, which translated into a dramatically fewer inches and lower dress sizes, it seemed as if everyone who did Crossfit became healthier. Lower cholesterol. Lower resting heart rates. Decreased blood pressure. Elevated moods. It looked like a move away from decrepitude and frailty was actually a move TOWARD health. Toward WELLNESS. A scientist at heart, Glassman digested this information and in 2008 made the following statement: fitness is a proxy for health. Indeed, Glassman declared that fitness EQUALS health. In this, Greg Glassman is right, or at least more right than not. At a minimum, fitness is the foundation upon which health is built. A healthy nation is one that need not expend countless $Billions on curing diseases that could be prevented by becoming fit. This is the first reason why he is the most dangerous man in American health care.

The second reason is that he doesn’t care.

Greg Glassman is like the little boy standing at the side of the road watching the naked emperor parade by who declares “the Emperor has no clothes!” He is standing there watching a parade of the fat and the weak and he is saying “hey look…they can’t get their butt off the throne!” It’s uncomfortable to hear someone say that, but he doesn’t care; it needs to be said. The standard dietary dogma of high carbohydrate, low-fat diets with little or no meat? A straight ticket to decrepitude! He doesn’t care that statements like that make all of the Oz’s and Pritiken’s sputter and squirm. When asked once upon a time how to gain weight for a movie role Glassman famously responded: “ easy…non–fat frozen yogurt.” It’s no different with exercise. Walking and other low-intensity exercises? Better than nothing, but only almost. Cue the howls of the Jillians and the Jakes, and every glossy, muscly, fitnessy magazine editor in the English speaking world. Glassman is right, and he doesn’t care.

Greg Glassman has looked at what is wrong with the health of Americans and he is willing to say what that is and say it out loud. He is willing to say that we as a people are unfit, and that this is the primary cause underlying our lack of health, and our accelerating need to spend money to cure disease. He is willing to say that the vast majority of the advice that we have received to fix this is flat out wrong, whether it comes from the government or the cover of Fitness Magazine. He is willing to say the the road to economic salvation in American Healthcare leads through the gym, the grocery store, and the kitchen, not to or through something as meaningless as an “Accountable Healthcare Organization” (whatever that may be). Although he is convinced that he is right he is presently spending gobs of his own money studying the effects of the Crossfit prescription on the health of regular people.

Yup, Greg Glassman is right, and he doesn’t care that all of the so–called experts in healthcare don’t know who he is yet, or that they wouldn’t agree with him if they did. Judging by what’s going on in the physical fitness world right now as Crossfit grows 30% PER MONTH, I’d say that makes Greg Glassman the most dangerous man in American healthcare.